Nurse Manager Power

Institutional Affiliation
Nurse Case Study – Nurse Manager Power
Available research shows that, there exists colossal injury caused by
the hostile relationship in healthcare (Rosenstein, 2002). Managers are
expected to create the code of conduct in the healthcare unit with main
aim of ensuring that, the action of one nurse does not affect the
activities of others and that professionalism is ensured. The staffs are
expected to adhere to the set code for a smooth running of the
healthcare. Mrs. Jackson is a nurse manager in a coronary healthcare
unit. She is known to have a habit of dictating to the nurses what they
should do, portrays favoritism and is suffering from superiority
complex. Her actions have invariably led to relationship constraints in
the healthcare unit.
Dictating to employees what to do whenever there is a problem has been
known to have enormous negative effects on the morale and effectiveness
of employees. This may be associated with the fact that nurses will feel
under pressure when performing their duties. This will not only maim
their capability to handle their duties diligently, but will also
increase their dependency on the manager such that incase an emergency,
they may not be able to carry on because there is no one to give
direction (Rosenstein, 2002). Dictatorial form of management has also
been attributed to reducing the drive, enthusiasm and zeal to perform
duties. When people are under duress the reaction becomes unpredictable.
In such a scenario this may been carried down to the patients who may
not get the best medical services.
Poor manager-nurse relationships are a major cause of horizontal
hostility. An individual or group that is made to feel inadequate and
toothless will always act out their disappointments and frustrations
towards their partners (Rosenstein & O’Daniel, 2005). If the manager
takes side and seems to favor some workers she may be creating animosity
of unknown magnitude among the nurses. This may not augur well in their
critical function of taking care of the sick. Hatred towards co-workers
can have disastrous impacts on overall output of the health unit. In a
situation like this where team work is crucial, forces acting against
strengthening the bonds may hinder communication. Poor manager-nurse
relationship is detrimental to the patients seeking health services and
teamwork (Rosenstein & O’Daniel, 2005).
Superiority complex is not only a self injuring trait, but also a great
demotivator. Mrs. Jackson’s superior attitude may not bode well in
ensuring a healthy atmosphere is created, thus enabling nurses to
conduct their duties as well as ensuring that they feel appreciated.
Making workers feel as if their services are not wanted or as if there
are not important to the healthcare may slowly but steadily kill the
motivation and zeal of the nurses (Rosenstein, 2002). Unhealthy working
environment can have negative effects on the nature and quality of care
delivered by the nurses. Superiority complex is a precursor of low staff
turnover. In worse scenarios, it may even lead to nurses leaving the
The core of creating a functional teamwork is ensuring that, every nurse
is made to feel their services are wanted and that, they are important
to the healthcare unit. Creating healthy environments, which starts by
making the nurses feel valued by the unit is an important leap to
ensuring a motivated workforce (Johnson, 2009). The processes need to be
standardized so that each nurse feels equal to the other in a bid to
eliminate horizontal animosity. Staff empowerment and recognition of
nurses in the strategic decision making may be crucial factors all but
put in place to promote teamwork and delivery of services. Optimal team
functioning also means that duties have to be shared without fear or
favor. The nurse manager need to recognize that delegating duties
without favor as compared to just ordering nurses to perform tasks based
on her judgement may actually be inhibiting service delivery and
mounting tensions among the nurses.
The manager should create an atmosphere where nurses are free to express
their opinions and ideas via fostering effective communication, through
collaborative relationship and including them in the decision making
process. Nurses will feel obliged to perform their duties diligently and
are more likely to value teamwork if they are involved in decision
making, leadership and management processes and other organizational
activities. This not only accords them an opportunity to work together
but also serves to create strong bonds among the nurses.
Allocating duties following a well formulated timetable may solve the
conundrum of favorism. Nurses will be assigned work not on the decision
of the manager because she likes some more than others but on a well
spelt and formulated program as well as making every member in the group
feel equal. Each nurse should be involved in the formulation process to
give them a sense of belonging. Working together to come up with a
timetable increases interaction and understanding of each member on the
traits and nature of the other members which may improve teamwork
(Johnson, 2009).
The supervisor may intervene and hold the manager accountable for
performance of the healthcare unit and employees grievances. The
supervisor may begin by garnering commitment from the operational
manager of the unit. He or she should clearly and succinctly state the
effects of poor relationship between the managers and nurses. Emphasis
should be put on the positive outcomes of collegial relation and the
manager should make deliberate efforts to improve the relationship with
the nurses. The manager can be encouraged to communicate on a weekly
basis with the nurses. Mrs. Jackson can also provide an update of the
concerns and queries of the nurses and the solutions that the manager
had proposed to address the concerns. The supervisor can also arrange
for a monthly meeting where they can all assemble and gather solutions
to problems that requires input from everyone.
Empowering the nurses to stand up for themselves and shun making excuses
for their negative behaviours can also be a possible remedy to the
problem (Rosenstein & O’Daniel, 2005). The supervisor should be
equivocal that, even the smallest of condescending behaviour on the part
of the manager or nurses is disastrous to the whole unit. If a nurse is
reluctant to approach the manager for reserved reasons, then the manager
should be ready to approach the nurse, speaking to them in the most
appropriate manner and show them that, their actions may be injurious to
the common goal of the team. Collaboration between the manager and
nurses is significant and the supervisor should link the two incase
there is a gap emplaning the relevance of remaining true to the
objectives and codes of the profession.
Johnson, C. (2009). “Bad Blood: Doctor-Nurse Behavior Problems Impact
Patient Care” The Physician Executive Journal of Medical Management,
35(6): 6-11.
Rosenstein, A. (2002). “The Impact of Nurse-Physician Relationships on
Nurse Satisfaction and Retention” American Journal of Nursing,
Rosenstein, A. & O’Daniel, M. (2005).”Disruptive Behavior and Clinical
Outcomes: Perceptions of Nurses and Physicians” American Journal of
Nursing, 105(1): 54-64.